ABSTRACT
The neurotransmitter pathways of nicotine addiction have direct relevance to pharmacogenetic approaches to smoking cessation.519 Identification of susceptibility genes may allow for targeted prevention and treatment of nicotine dependence and withdrawal. The major barrier to quitting smoking is nicotine addiction. Only about 20 percent of individuals respond to smoking cessation treatments with long-term abstinence,520 suggesting that variability in the intensity of nicotine addiction may correlate with treatment efficacy. Pharmacotherapy and behavioral counseling are both effective approaches to managing nicotine addiction and smoking cessation.520 Nicotine replacement products (gum, patch, lozenge, inhaler, or nasal spray) provide an alternative source of nicotine to the addicted individual allowing some smokers to quit successfully. Resulting from the understanding of the nicotine metabolism pathways, small studies of inhibitors of CYP2A6 enzyme have been demonstrated to reduce smoking intensity.476 In the future, individuals in trials of nicotine replacement may be stratified by genetic variants that may predict response to nicotine replacement or enzyme inhibition.
